The hypothesis tested in this study was that the septal myectomy operation for palliative treatment of hypertrophic cardiomyopathy was equally worthwhile in those 65 years and older as has been shown for younger patients. 52 patients for whom complete data were available for greater than 5 years after the operation or until death comprised the study. The mean age was 69 plus or minus 3 years (range 65-81) 57% of whom were female. 41 patients had no coronary artery disease (CAD) requiring surgical palliation. The remainder had CAD. 82 and 95% reduction in peak left ventricular outflow pressure gradients was achieved in the two groups, respectively. An 8% hospital mortality and 75 plus or minus 8% 5 year survival was achieved in those without CAD. Those with CAD had increased hospital mortality and lower 5 year survival rates. These data support the clinical impression that older age is not a contraindication to operative palliation although the presence of significant CAD increases risk.